Laser treatment for CNS injury

ABSTRACT

Techniques disclosed herein include systems and methods for treating spinal cord injury. Techniques include using a diode laser assembly, a power source, a fiber optic cable, and a fenestrated tip. The power source can be connected to the diode laser assembly, with a fiber optic cable connected to the diode laser assembly. The fenestrated tip is connected to the fiber optic cable to emit a plurality of laser light beams produced by the diode laser assembly at a location remote from the diode laser assembly. The apparatus can be used in a method for treating a spinal cord injury. The method is carried out by providing a source of laser light having a wavelength in the range of 500-1000 nm and a power in the range of 5 to 500 milliwatts. The laser light is transmitted through an optical wire to a position adjacent a spinal cord injury site, with at least a portion of the apparatus positioned within a human body. The spinal cord injury site is then irradiated with laser light from the optical wire.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application claims the benefit of U.S. Provisional PatentApplication No. 61/376,033, filed on Aug. 23, 2010, entitled “ImplantedLaser Treatment For Injuries,” which is incorporated herein by referencein its entirety.

BACKGROUND

The present disclosure related to treating injuries, especially injuriesto the central nervous system, such as spinal cord injuries.

The central nervous system (CNS) is an integral part of the biology ofhumans and animals. The central nervous system typically includes thecombination of the brain and spinal cord. The CNS integrates informationreceived from all parts of the body, and coordinates activity of bodyparts. Accordingly, a healthy CNS is crucial to proper functioning of abody. Injuries to the central nervous system, especially spinal cordinjuries, can therefore inhibit and even prevent proper bodyfunctioning. For example, a CNS or spinal injury can result in pain,numbness, loss of sensation, unresponsive muscles, loss of connectionbetween the brain and body, difficulty breathing, partial paralysis, andeven complete paralysis.

Damage to the spinal cord can result from diseases and from physicaltrauma. Motor vehicle collisions, falls, sports injuries, andwork-related accidents are common physical causes of spinal cord injury.Treatment of spinal cord injuries depends on type and severity of theinjury itself. Treatments can include medication, surgery, and physicaltherapy.

SUMMARY

Conventional techniques for treating spinal cord injuries include directexposure to laser light. Studies have shown that transcutaneous as wellas direct exposure to laser light can assist in regenerating injuredcells. Yet conventional techniques suffer from a variety ofdeficiencies. For example, U.S. Patent Application Publication Number2006/0036299 (Feb. 16, 2006) discloses a transcutaneous treatment of aspinal cord injury (SCI) by applying low-power laser irradiation (LPLI).A drawback of this method, however, is that tissue penetration of laserlight is only on the order of 0.05 cm for each watt of power input, andeven less in bone. The relatively small amount of tissue penetration canlead to applying relatively high intensity light to the skin surface toprovide adequate power to the site of the SCI. Unfortunately thehigh-intensity light on the skin surface can cause adverse effects.Another drawback is that the laser light is focused in a small area,requiring that the beam be reoriented from time to time, or that asecond beam is used to help cover an entire site.

Accordingly, there is a desire for a more efficacious laser treatment ofspinal cord injuries. Techniques disclosed herein provide a method anddevice that treats injuries to the central nervous system, includingspinal cord injuries, by controlled exposure to laser light.

One embodiment includes a method for treating a spinal cord injury. Themethod includes using a source of laser light having a wavelength in therange of 500-1000 nm and a power in the range of 5 to 500 milliwatts.Laser light is transmitted through an optical wire or conduit to aposition adjacent a spinal cord injury site. The spinal cord injury siteis then irradiated with laser light from the optical wire.

Another embodiment of the invention includes an apparatus comprising adiode laser assembly, a power source, a fiber optic cable, and afenestrated tip. The power source is connected to the diode laserassembly. The fiber optic cable is connected to the diode laserassembly. The fenestrated tip is connected to the fiber optic cable toemit a plurality of laser light beams produced by the diode laserassembly at a location remote from the diode laser assembly. Such alaser device can be implantable.

Of course, the order of discussion of the different steps as describedherein has been presented for clarity sake. In general, these steps canbe performed in any suitable order.

As discussed above, techniques herein are well suited for use in CNS andspinal cord injury treatments. It should be noted, however, thatembodiments herein are not limited to use in such applications and thatthe techniques discussed herein are well suited for other applicationsas well.

Additionally, although each of the different features, techniques,configurations, etc. herein may be discussed in different places of thisdisclosure, it is intended that each of the concepts can be executedindependently of each other or in combination with each other.Accordingly, the present invention can be embodied and viewed in manydifferent ways.

Note that this summary section herein does not specify every embodimentand/or incrementally novel aspect of the present disclosure or claimedinvention. Instead, this summary only provides a preliminary discussionof different embodiments and corresponding points of novelty overconventional techniques. For additional details and/or possibleperspectives of the invention and embodiments, the reader is directed tothe Detailed Description section and corresponding figures of thepresent disclosure as further discussed below.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other objects, features, and advantages of theinvention will be apparent from the following more particulardescription of preferred embodiments herein as illustrated in theaccompanying drawings in which like reference characters refer to thesame parts throughout the different views. The drawings are notnecessarily to scale, with emphasis instead being placed uponillustrating the embodiments, principles and concepts.

FIG. 1 is an example laser light device according to embodiments herein.

FIG. 2 is an example section of a laser light device according toembodiments herein.

FIG. 3 is a cross sectional view of an example laser light deviceaccording to embodiments herein.

FIG. 4 is a longitudinal sectional view of an example laser light deviceaccording to embodiments herein.

FIG. 5 is a schematic diagram of a laser light system for treating aspinal cord injury according to embodiments herein.

FIG. 6 is a diagram showing positioning of a laser light device in apatient for treatment of a spinal cord injury according to embodimentsherein.

FIG. 7 is a diagram of a tip section of a laser light device accordingto embodiments herein.

FIG. 8 is an example end view of a tip of a laser light device accordingto embodiments herein.

DETAILED DESCRIPTION

Techniques disclosed herein provide a method and device that treatsinjuries to the central nervous system, including spinal cord injuries,by controlled exposure to laser light.

One embodiment includes a method for treating a spinal cord injury. Themethod includes using a source of laser light having a wavelength in therange of 500-1000 nm and a power in the range of 5 to 500 milliwatts.Laser light is transmitted through an optical wire or conduit to aposition adjacent to a spinal cord injury site. The spinal cord injurysite is then irradiated with laser light from the optical wire.

Preferably, the source of laser light provides light having a wavelengthin the range of 730-830 nm and a power delivery in the range of 15 to 90milliwatts. More specifically, the source of laser light can selectivelyemit a laser light having a wavelength selected from one of amultiplicity of accessible wavelengths from within the 730 to 830 nmrange, and selectively emit a laser light having a power selected fromone of a multiplicity of accessible power levels from within the 15 to100 milliwatt range. Note that at about 830 nm, light absorption innerve cells, dermis, and hemoglobin is optimal.

There are several cellular effects that can result from wavelengthsaround 830 nm. For example, one effect is stabilization of cellularmitochondrial membranes with measurements of Ca, Na, and K iongradients. Adenosine-triphosphate (ATP) production is enhanced, therebyproviding energy for cell replication, repair and peptide production.Cellular release of histamine, serotonin and CO2 produces additionalvasodilatation and increased blood flow and levels of INF-g. Thisincreased blood flow can be further increased by prostaglandinsynthesis. There is also a reduction of the IL 1 and TNF improvedanti-inflammatory effect on cells. A reduction of inflammation inducesnormal function of the astrocyte neuron lactate shuttle, and thusincreases the efficacy of lactate for use by neuronal mitochondria forATP production. This increased ATP production stabilizes intracellularwater polarization onto protein organelles (actin and microtubules),thus impeding cell death. Cellular effects also include a decrease ofinflammatory cellular response by production of TH2 T cells andsuperoxide dismutase, as well as non-specific effects of an 830 nm laseron other inflammatory markers such as C reactive protein, macrophageproduction, neo-vascularation, fibroblast proliferation, epithelial cellregeneration, and increase in DNA synthesis.

The optical wire can be comprised of a plurality of optical fibers. Theoptical wire can also be terminated by a fenestrated tip and encased ina sheath that that covers the plurality of optical fibers, and thatextends from the tip. A number of optical fibers included in theplurality can be any suitable or feasible number. The number can dependon various factors such as optical wire thickness, available power,sheathing constraints, etc. The number can also be arbitrarily selected.For example, the optical fibers can be between 10 and 100 in number. Thefenestrated tip can have a window opening for transmission of laserlight from each of the optical fibers. In other embodiments, thefenestrated tip can have window openings for emitting laser light at anangle from a longitudinal axis of the tip. For example, the fenestratedtip can have window openings in a rounded end face of the tip foremitting a plurality of laser light beams in a spreading axial patternfrom the tip, or window openings through a sidewall of the tip foremitting a plurality of laser light beams laterally from the tip.

In one technique, the tip can be placed in a position adjacent to agiven spinal cord injury site and within two cm of the injury, and evenwithin one cm of the injury. The tip can also be positionedsubcutaneously or, alternatively, in an epidural space either alongsidethe injury or pointed toward the injury. Exact orientation can depend ona particular configuration of the tip. In some embodiments, the sourceof laser light can be implanted in the patient. Implanting the laserlight in the patient can be beneficial as a means for relief fromchronic pain.

Another embodiment of the invention includes an apparatus comprising adiode laser assembly, a power source, a fiber optic cable, and afenestrated tip. The power source is connected to the diode laserassembly. The fiber optic cable is connected to the diode laserassembly. The fenestrated tip is connected to the fiber optic cable toemit a plurality of laser light beams produced by the diode laserassembly at a location remote from the diode laser assembly. Such alaser device can be implantable.

The fenestrated tip can have a plurality of window openings in arounded-end face of the tip for emitting a plurality of laser lightbeams in a spreading axial pattern from the tip. In another preferredembodiment of the invention, the fenestrated tip has a plurality ofwindow openings through a sidewall of the tip for emitting a pluralityof laser light beams laterally from the tip.

Referring now to FIGS. 1-4, an optical fiber bundle can comprise aplurality of optical fibers 110 bundled or aligned parallel to eachother, and can then terminate at a fenestrated tip section 120. FIG. 2shows an example bundle of optical fibers 110, which can be encasedwithin a sheath 115 or other covering. The sheath 115 can extend from atip section of a bundle to a diode laser assembly 130, thereby coveringthe bundle. A number of optical fibers selected can vary on applicationof the apparatus. For example, in some embodiments, the bundle caninclude between two and one hundred optical wires or more. In otherparticular embodiments, a number of optical wires between three andtwenty can be beneficial. FIG. 1 illustrates a laser treatment apparatus105 having an implantable electronics pack 130 and a fenestrated tipsection 120. The fenestrated tip section 120 can include one or morewindow openings for transmission of laser light from each optical fiberincluded in the bundle. In some embodiments, the fenestrated tip section120 can include window openings for emitting laser light at an angle, orat a plurality of angles, such as from a longitudinal axis of the tipsection. For example, the fenestrated tip section can have windowopenings in a rounded-end face of the tip section adapted for emitting aplurality of laser light beams in a spreading axial pattern from a tipsection. FIG. 4 shows a sectional view of an example tip section with anaxial spreading pattern. In another embodiment, window opening can bedefined through a sidewall of the tip section for emitting a pluralityof laser light beams laterally from the tip section. An example of a tiphaving a lateral light emission pattern is shown in FIG. 7.

FIG. 1 also shows sidewalls 121. Particular embodiments can include oneor more sidewalls in addition to a tip or in place of a fenestrated tip.Such sidewalls 121 can be thought of as paddles or bands, which arelaser light emission surfaces along an optical fiber or optical fiberbundle to emit a portion of the laser light. Each laser light emissionsurface can include one or more apertures, lenses, or other lighttransmission points to emit laser light carried by one or more fiberoptic lines. A number an size of light transmission points can bedependent on a particular application. For example, for small lesions agiven sidewall may contain only a handful of transmission points, whilefor larger lesions the sidewall can span an inch or two in length andhave dozens of transmission points. Having more light transmissionpoints then needed can help increase regeneration, and account formovement of the device within a human body. In other embodiments, thesidewall area can span several inches to cover a large legion.Alternatively, several sidewalls can be used at strategic points

By way of a non-limiting example, an outside diameter of an opticalfiber bundle and sheath (the combination being referred to as acatheter) for insertion in a spinal column can be in the range of about0.3 to 0.6 cm, with about 3-20 optical fibers. Each optical fibergenerally carries laser light at a power in the range of 1-30 watts. Anexample catheter can have a length of about 5-50 cm. Note that thesespecifications can be modified depending on a particular application.

FIGS. 5 and 6 show a diagram illustrating placement of a laser treatmentdevice. During treatment of a spinal cord injury, a tip section can bepositioned adjacent to a spinal cord injury site 160. Treatment caninclude positioning windows of the fenestrated tip within about twocentimeters of at least a portion of the injury, and can includepositioning the tip within about one centimeter of the injury. In someembodiments, the tip section can be positioned subcutaneously. In sometreatment conditions, however, placement can be more effective in otherlocations. For example, an alternative placement location is theepidural space between dura mater 162 and the spinal cord 164. Placementcan either be alongside the injury or longitudinally spaced from theinjury, but with the windows pointed toward the injury site 160,depending on a given tip configuration. In other words, the tip can bepositioned so that laser light 172 impinges the injury. Optionally, thesource of the laser light can be implanted within a patient, such aswhen a purpose of placement is relief from chronic pain or an extendedtreatment cycle.

In another embodiment, a laser treatment apparatus 105 comprises a diodelaser assembly 133, a power source 135, optical fiber bundle 111, and afenestrated tip section 120. The fenestrated tip section 120 can beconnected to the fiber optic cables and adapted to emit a plurality oflaser light beams produced by the diode laser assembly, but at alocation relatively remote from the diode laser assembly.

Referring now to FIGS. 3 and 4, the fenestrated tip section 120 can havea plurality of window openings 124 in a rounded-end face of the tipsection for emitting a plurality of laser light 172 in a spreading axialpattern from the tip section. In another embodiment, the fenestrated tipsection 120 has a plurality of window openings 124 through a sidewall ofthe tip section for emitting multiple laser light 172 laterally from thetip section.

Returning to FIGS. 1-3, a 730-930 nm laser treatment apparatus 105 canbe introduced into the epidural space via an insulated fiber opticcable, adapted to deliver a current (e.g. 15-90 milliwatts), through afenestrated tip 120 at the end of the fiber optic sheath 115. A cathetercan be directed under fluoroscopic guidance to a region of suspectedtrauma or lesion. FIG. 6 shows an example of such fluoroscopic guidance.FIG. 6 shows an apparatus similar to that shown in FIG. 5, but withplacement along a spine to provide adjacent emission of laser light.Once the region is determined, the device can be implantedsubcutaneously. Electronics pack 130 or generator (which can comprisethe diode laser and battery pack or other power source) can also beimplanted and attached to the cable as a source of energy. Note thattranscutaneous as well as direct exposure to laser light can be usefulin the course of regenerating nerve cells. In an additional technique,directing the laser beam to multi-synaptic pain pathways can helprelieve chronic pain. For chronic pain applications, the laser lighttherapy can be used more for stimulation rather than cellularregeneration.

By way of a non-limiting example, one particular example device caninclude a triple diode laser configured to deliver an output of severalfrequencies and power settings. For example, a given device can emit at760 nm, 810 nm and/or 830 nm laser emission, with power settings of 15mW, 30 mW, 60 mW, and 90 mW. Tissue penetration is typically 0.05 cm pereach mw output at each of the laser frequencies. Such a laser diode canbe affixed on a base of an insulated fiber sterile cable. This cable canbe attached to the diode laser, which can have a plug-in power sourceconfigured to be inserted in a tissue pocket formed in a patient.Alternatively, a laser diode array can be used in conjunction withmultiple fiber optic lines.

The fiber optic cable effectively carries the laser light directly totissues to be lased. The diode laser can have a programmable controllerto deliver 1,589 Joules/cm squared per day to an area of damage. Thisparticular laser dosage can provide effective neuronal regeneration.Regarding notation, Energy (Joule)=Mean Power (W)×Time (sec). Also,Energy=30 mW×33 Sec=0.99 Joule.

Regarding placement, under fluoroscopic control, the fiber opticcatheter can be placed in juxtaposition of the spinal cord, nerve rootor other tissue that has been damaged and sutured in place. Exampledevices can be used to regenerate other tissues besides the spinal cord,such as brain tissue, with placement of the device in correspondingareas of the body. In one example, the diode laser can be attached and abattery pack placed in position and sutured in order to provide maximumprotection and fixed placement.

Use of a “cold laser” with frequencies of 760, 810 and/or 830 nm withenergy output of 30, 60 or 90 mW can result in axonal and functionalregeneration of injured neurons in peripheral nerves, nerve roots and inthe spinal cord following injury and/or hemisection or transaction. Thedepth of penetration of a given laser beam can depend upon frequency(nm) and output (mW). Optimal soft tissue penetration in some humans isbetween 670 nm and 850 nm. Proper laser power penetration of the nervetissue of the spinal cord can significantly increase axonal re-growthleading to functional recovery following significant spinal cord damage.This process will be vitally important in trauma to the spinal cordfollowing diving accidents, automobile accidents, sports injuries andother trauma. In addition, specific anterior lateral spinal cordplacement of the laser light can be useful in blocking chronic painsyndromes and severe intractable pain syndromes associated, for example,with metastatic cancer.

One embodiment includes a method for treating an internal bodily injury(such as a spinal cord injury). The method includes providing a sourceof laser light having a wavelength in the range of 500-1000 nm and apower in the range of 5 to 500 milliwatts. The method includestransmitting the laser light through an optical wire, with the laserlight being transmitted from the source of the laser light to a locationadjacent to a bodily injury site. The optical wire is connected to alight emission surface positioned adjacent to the spinal cord injurysite. The light emission surface is adapted to emit laser light from theoptical wire to the spinal cord injury site. The light emission surfacecan be a lens, window, aperture, or simply the end of a fiber optic wire(with the end surface oriented approximately perpendicular to alongitudinal direction of the optical wire such that light escapes theoptical wire at that point). The light emission surface can includemultiple light emission points. The light emission surface and at leasta portion of the optical wire are positioned within a human body. Themethod then includes irradiating the bodily injury site with the laserlight carried via the optical wire.

In other words, the method includes treating a spinal cord injury sitewith laser light from within the human body, that is, the laser light isemitted onto/into an injury site from a location within the human body,thereby assisting cellular regeneration. Conventional laser treatmentsare external to the body and powered to destroy cellular or bodilystructures, whereas techniques disclosed herein use laser treatment forregeneration, with internal emission to directly heal neuropathways.

In various alternative embodiments, the source of laser light can have awavelength in the range of 730-830 nm and a power in the range of 15 to90 milliwatts, which can provide better results in some applications.The light emission surface can be positioned within about 2 centimetersof the injury site or positioned within about 1 centimeter of the injurysite. The optical wire and light emission surface(s) can be positionedsubcutaneously, positioned in the epidural space of a human spinalcanal, positioned near the brain stem, cranial nerves, eye nerves,facial nerves, positioned within or next to organs, etc.

The method can include implanting the source of laser light, opticalwire, and tip all within the human body. Placement within the body canbe either temporary or indefinite. For example, for treating acuteinjuries, treatment can include implanting the laser light apparatuswithin the body for a few months to half a year or year, after which theapparatus can be removed. For treating chronic conditions, the apparatuscan be left in the body indefinitely, including implanting a batterysource. The battery source can be configured with a rechargeable batterythat can be recharged externally using a wireless power charger.External recharging means no surgical replacement of the battery afterlosing a charge. For spinal cord placement, placement can be in front ofthe spine, in back of the spine or other area within the body. Placementcan be executed using a catheter and/or in combination

The source of laser light can selectively emits a laser light having awavelength selected from one of multiple selectable wavelengths. Forexample, there can be several predetermined laser settings, on or moreof which a surgeon can select prior to positioning and implanting thedevice. Other embodiments include wireless tuning of the laser light viaa remote control. This can include turning off the laser, selecting alight pattern (pulsed, continuous, etc.), and selecting or adjustingwavelength and power output from multiple selectable power levels.

The optical wire can comprise a plurality of optical fibers grouped orbundled together. The bundled optical fibers can extend from the lasersource to the injury site. Alternatively, a bundle of optical fibersextends from a single fiber at or near an emission tip of the device. Inparticular embodiments, a number of optical fibers in the plurality ofoptical fibers can be between 10 and 100.

In another embodiment, the method includes emitting the light using afenestrated tip or other light diffusion mechanism. The fenestrated tipcan have an emission surface(s) for transmission of laser light fromeach of the optical fibers. Emission surfaces can be adapted foremitting the laser light at an angle relative to a longitudinal axis ofthe fenestrated tip. The fenestrated tip can be embodied as a roundedend that defines light emission openings, windows, or lenses in thefenestrated tip. These light emission openings can be configured to emita plurality of laser light beams in a spreading axial pattern relativeto the fenestrated tip. Having broad laser light emission coverageassists in keeping laser light flooding an injury site despite minormovements in positioning caused by movement of a corresponding humanbody. Alternatively, the fenestrated tip includes a sidewall thatdefines light emission openings in the fenestrated tip, with the lightemission openings configured to emit a plurality of laser light beamsfrom the sidewall. Other embodiments can include a sheath that coversthe optical fibers from the first end of the optical fibers to thesecond end of the optical fibers, that is, from the laser source to alaser light emission point or diffusion tip.

Another embodiment includes a method for treating a spinal cord injury,a brain injury, or other nerve injury. This method includes providing asource of laser light having a wavelength in the range of 500-1000 nmand a power in the range of 5 to 500 milliwatts. The laser light cancome from a diode laser or other laser generator with a battery or otherpower supply. The generated laser light is transmitted through anoptical wire to a location adjacent to a spinal cord injury site. Theoptical wire has a first end and a second end. The first end of theoptical wire is connected to the source of the laser light (such as adiode laser apparatus), while the second end of the optical wire isadapted to emit the laser light from the optical wire to the spinal cordinjury site. The second end can thus have a terminal, lens, or otheremission surface that permits the laser light to be emitted from theoptical wire to the injury site. The second end of the optical wire, andat least a portion of the optical wire, are positioned within a humanbody, that is, at least under the skin surface of a human body. Themethod then includes irradiating the spinal cord injury site with thelaser light carried via the optical wire.

In another embodiment, an injury treatment apparatus includes a diodelaser assembly, a power source connected to the diode laser assembly, afiber optic cable connected to the diode laser assembly, and a lightemission surface connected to the fiber optic cable. The light emissionsurface is adapted to emit a plurality of laser light beams produced bythe diode laser assembly. The laser light beams are emitted at alocation remote from the diode laser assembly. The light emissionsurface is adapted to be positioned within a human body. The lightemission surface can includes a plurality of laser light emissionsurfaces, in a rounded-end face of a fenestrated tip, and configured toemit a plurality of laser light beams in a spreading axial patternrelative to the fenestrated tip. Alternatively, the light emissionsurface includes a plurality of light emission surfaces, in a sidewallof the fiber optic cable, configured to emit a plurality of laser lightbeams laterally relative to the fiber optic cable.

In another embodiment, a laser therapy treatment device can include adiode laser assembly, a power source connected to the diode laserassembly, a fiber optic cable connected to the diode laser assembly, andone or more laser light emission surfaces located along the fiber opticcable, such as at an end of the fiber optic cable, or at various pointsalong a sheath containing the fiber optic cable or fiber optic cablebundle. Alternatively a fenestrated tip is connected to the fiber opticcable adapted to emit a plurality of laser light beams produced by thediode laser assembly. The laser light beams are emitted at a locationremote from the diode laser assembly. The fenestrated tip or sidepaddle/emission surfaces can be adapted to be positioned within a humanbody. Each side surface can have one or more lenses, apertures, orwindows for laser light to be emitted. In some embodiments, thefenestrated tip can defines a plurality of laser light emissionsurfaces, in a rounded-end face of the fenestrated tip, that areconfigured to emit a plurality of laser light beams in a spreading axialpattern relative to the fenestrated tip. Alternatively, the device caninclude a plurality of light emission surfaces along a fiber optic lineor sheath on a sidewall of the fiber optic line. Each side surface candefine apertures or contain lenses/light emission surfaces that emit aplurality of laser light beams laterally relative to a fiber optic laserlight transmission line.

Those skilled in the art will also understand that there can be manyvariations made to the operations of the techniques explained abovewhile still achieving the same objectives of the invention. Suchvariations are intended to be covered by the scope of this invention. Assuch, the foregoing description of embodiments of the invention are notintended to be limiting. Rather, any limitations to embodiments of theinvention are presented in the following claims.

The invention claimed is:
 1. A method for treating a spinal cord injury,the method comprising: providing a source of laser light having awavelength in the range of 730-830 nm and a power in the range of 15 to90 milliwatts; transmitting the laser light through an optical wire, thelaser light being transmitted from the source of the laser light to alocation adjacent to a spinal cord injury site, the optical wireconnected to a light emission surface positioned adjacent to the spinalcord injury site, the light emission surface adapted to emit laser lightfrom the optical wire to the spinal cord injury site, the light emissionsurface and at least a portion of the optical wire being positionedwithin a human body; disposing a plurality of the optical wires in abundle, each of the optical wires terminating in a window defining thelight emission surface; arranging a subset of the windows in a sidewallof a fenestrated tip, the sidewall facing the spinal cord injury site;arranging a subset of the windows in a rounded end face, the roundedended face orienting the windows in an axial spreading pattern directedtoward the spinal cord injury site; and irradiating the spinal cordinjury site with the laser light carried via the optical wire, theoptical wire and the light emission surface are positionedsubcutaneously.
 2. The method of claim 1, wherein the light emissionsurface is positioned within 2 centimeters of the spinal cord injurysite.
 3. The method of claim 1, wherein the light emission surface ispositioned within 1 centimeter of the spinal cord injury site.
 4. Themethod of claim 1 wherein at least a portion of the optical wire and thelight emission surface are positioned in epidural space of a humanspinal canal.
 5. The method of claim 1, further comprising implantingthe source of laser light within the human body.
 6. The method of claim1, wherein the source of laser light selectively emits a laser lighthaving a wavelength selected from one of multiple selectablewavelengths.
 7. The method of claim 1, wherein the source of laser lightselectively emits a laser light having a power selected from one ofmultiple selectable power levels.
 8. The method of claim 1, wherein theoptical wire comprises a plurality of optical fibers grouped together.9. The method of claim 8, wherein a number of optical fibers in theplurality of optical fibers is between 10 and
 100. 10. The method ofclaim 9, further comprising emitting the laser light using a fenestratedtip.
 11. The method of claim 10, further comprising a sheath that coversthe optical fibers from the first end of the optical fibers to thesecond end of the optical fibers.
 12. The method of claim 10, whereinthe fenestrated tip has an emission surface for emission of laser lightfrom each of the optical fibers.
 13. The method of claim 12, wherein thefenestrated tip includes emission surfaces adapted for emitting thelaser light at an angle relative to a longitudinal axis of thefenestrated tip.
 14. The method of claim 13, wherein the fenestrated tipincludes a rounded end that defines light emission openings in thefenestrated tip, the light emission openings configured to emit aplurality of laser light beams in a spreading axial pattern relative tothe fenestrated tip.
 15. The method of claim 13, wherein the fenestratedtip includes a sidewall that defines light emission openings in thefenestrated tip, the light emission openings configured to emit aplurality of laser light beams from the sidewall.
 16. The method ofclaim 1 further comprising disposing the light emission surface in anepidural space between the dura mater and the spinal cord of a patientsuch that the windows of the light emission surface are disposed pointedtoward the spinal cord injury site.
 17. The method of claim 1 furthercomprising disposing the light emission surface in an epidural spacebetween the dura mater and the spinal cord of a patient such that thewindows of the light emission surface are disposed pointed toward thespinal cord injury site.